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PROSPECT INFORMATION FORM

Directions: Please fill out all sections of this information sheet as complete as possible. Click the send button at the bottom of the page. You will then be shown a confirmation page indicating that your information has been sent.

Personal Information

First Name Last Name
Address
City State Zip
Phone
E-Mail
Age Date of Birth Year of Graduation

Academics

SAT
Math
Verbal Writing
ACT
SAT II
Eng. Comp
Math Other
Class Rank of GPA
Desired Field(s) of Study
Do you need Financial Aid?
Other Colleges you are Considering
Please List Alumni You Know
Please List Students You Know

School

Current School School Phone
Coach's Name Coach's Phone
Guidance Counselor Principal

Family Information

Father's Name Occupation
Mother's Name Occupation
Others living at home
Others in College

Wrestling Information

Weight Class Height, Weight
Honors Received
Other Sports/Position


For

Contact: Brian Laubscher
Sports Information Director
PO Drawer 928
Lexington, VA 24450
Phone: 540-463-8670